Published on Mar 15, 2017
Order Taken: WebSite Order 3/13/17 / Shipped 3/15/17
PA: Lone Star Podiatry / Austin, TX / Dr. Cassidy
RX: Clyde's X1 GoBlade for Great Toe Arthritis - Left
DX: Left Arthritis Foot / Left Stress Reaction Foot / Left Pain in Foot
ICD-10-CM Billing Code : M13.172 / M84.872 / M79.672
Plan: Fabricate X1 GoBlade #7426 with StifFlex midfoot for natural ankle motion. Add .003" to great toe and heel relief. Maintain rocker shape forefoot. Pad heel with1/8" perf plastizote for heel strike relief to prevent plantar fasciitis. Please cover great toe relief zone with ShearBan to prevent blistering during heavy activity. Required thickness and weight of X1 GoBlade #7426 - 1/25" (.04") .0478 oz.
Sport: Running
Comments: Dr. Cassidy would like a X1 GoBlade for a patient - left foot woman's size 8 1/2. Runner model. Marlene
Website: www.indianabrace.com
Contact: Call: 800-253-6217 Text: 317-445-1475 Email: clyde.peach@indianabrace.com
Practitioner: Clyde Peach, CO - ABC Certified Orthotist #1321
American Board for Certification in Orthotics & Prosthetics
PA: Lone Star Podiatry / Austin, TX / Dr. Cassidy
RX: Clyde's X1 GoBlade for Great Toe Arthritis - Left
DX: Left Arthritis Foot / Left Stress Reaction Foot / Left Pain in Foot
ICD-10-CM Billing Code : M13.172 / M84.872 / M79.672
Plan: Fabricate X1 GoBlade #7426 with StifFlex midfoot for natural ankle motion. Add .003" to great toe and heel relief. Maintain rocker shape forefoot. Pad heel with1/8" perf plastizote for heel strike relief to prevent plantar fasciitis. Please cover great toe relief zone with ShearBan to prevent blistering during heavy activity. Required thickness and weight of X1 GoBlade #7426 - 1/25" (.04") .0478 oz.
Sport: Running
Comments: Dr. Cassidy would like a X1 GoBlade for a patient - left foot woman's size 8 1/2. Runner model. Marlene
Website: www.indianabrace.com
Contact: Call: 800-253-6217 Text: 317-445-1475 Email: clyde.peach@indianabrace.com
Practitioner: Clyde Peach, CO - ABC Certified Orthotist #1321
American Board for Certification in Orthotics & Prosthetics
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